Exploring Developmental and Behavioral Heterogeneity among Preschoolers with ASD: A Cluster Analysis on Principal Components

Zheng, Shuting; Hume, Kara; Able, Harriet; Bishop, Somer; Boyd, Brian A.

doi:10.1002/aur.2263

Cited by 37 publications

(26 citation statements)

References 51 publications

(74 reference statements)

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“…The first one, which represented ∼43% of the sample, underwent great cognitive and adaptive skill improvements (High responders: HR) and the second one, which represented ∼19% of our sample, saw a widening of the gap increased over time compared to typical development in cognition and adaptative behavior (Minimal responders: MR). The clear distinction between toddlers with mild cognitive delay (HB) on one side and others with the more severe cognitive delay at baseline (LF) on the other is very close to results reported by previous studies that applied CA on preschoolers with ASD (52)(53)(54). These studies identified at least two subgroups categorized as high- and low-functioning based on early cross-sectional cognitive measures.…”

Section: Discussionsupporting

confidence: 85%

Distinct patterns of cognitive outcome in young children with autism spectrum disorder receiving the Early Start Denver Model

Godel

Robain

Kojovic

et al. 2021

Preprint

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Evidence-based early intervention approaches have been shown to significantly improve many areas of development in young children with autism. Despite having an overall positive impact for most children, there is high inter-individual heterogeneity of response to treatment, and it is currently not possible to predict which child will benefit from which specific intervention. In this study, we analyze developmental trajectories of young children with autism who received two-years of Early Start Denver Model intervention in Geneva, Switzerland (n=47). Using cluster analyses, we distinguish between 3 subgroups based on cognitive level at baseline and rates of change over time. The first subgroup of children had cognitive scores at baseline only slightly below what would be expected for their age and were found to have nearly no cognitive delay by the end of treatment (High at Baseline: HB). The children in the two other subgroups all presented with severe cognitive delay at baseline, with the second group′s cognitive scores improving significantly in the first year of intervention, along with increased communication and daily living skills (High Responders: HR). The third subgroup showed little to no cognitive level change over the course of treatment (Minimal Responders: MR). Furthermore, the rates of change in cognition and adaptative behavior in the HR subgroup were already significantly higher compared to the MR subgroup within the first 6 months of intervention. A rapid and early response to intervention might thus represent a predictor of optimal outcome. Inversely, slower progress by the sixth month of intervention may predict that the child will have a slower response to the treatment overall and may need alternative supports to reach their learning objectives quickly.

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Section: Discussionsupporting

confidence: 85%

Distinct patterns of cognitive outcome in young children with autism spectrum disorder receiving the Early Start Denver Model

Godel

Robain

Kojovic

et al. 2021

Preprint

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“…By testing measurement invariance, it is possible to determine whether a factor structure is stable across subgroup membership defined by such variables ( 85 ). Since heterogeneity in ASD and ADHD is influenced by age ( 86 – 88 ), sex ( 89 – 91 ), and adaptive functioning ( 92 – 94 ), these are important variables to consider when examining measurement invariance. It would also be helpful to determine whether the underlying factor structure of ASD and ADHD symptoms is stable across time in the same group of individuals used in longitudinal studies.…”

Section: Discussionmentioning

confidence: 99%

Latent Structure of Combined Autistic and ADHD Symptoms in Clinical and General Population Samples: A Scoping Review

et al. 2021

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Background: Many phenotypic studies have estimated the degree of comorbidity between Autism Spectrum Disorder (ASD) and Attention Deficit Hyperactivity Disorder (ADHD), but few have examined the latent, or unobserved, structure of combined ASD and ADHD symptoms. This is an important perquisite toward better understanding the overlap between ASD and ADHD.Methods: We conducted a scoping review of studies that examined the factor or latent class structure of ASD and ADHD symptoms within the same clinical or general population sample.Results: Eight studies met final inclusion criteria. Four factor analysis studies found that ASD and ADHD domains loaded separately and one found that some ASD and ADHD domains loaded together. In the three latent class studies, there were evidence of profiles with high levels of co-occurring ASD and ADHD symptoms.Conclusions: Our scoping review provides some evidence of phenotypic overlap between ASD and ADHD at the latent, or unobserved, level, particularly when using a “person-centered” (latent class analysis) vs. a “variable-centered” (factor analysis) approach.

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“…Greater SCI and RRBI corresponded to the most numerous subgroup (56%), whereas fewer participants (10%) made up the subgroup with less SCI and relatively high scores on RRBI. Moreover, based on the levels of RRBI, rather than on the social aspects of autism, Zheng et al [7] reported three subgroups of children with ASD without ID. In parallel, all the subgroups differed on an extended spectrum of clinical behavioral and adaptive measures.…”

Section: Discussionmentioning

confidence: 99%

Subgroups of Children with Autism Spectrum Disorder without Intellectual Disability: A Longitudinal Examination of Executive and Socio-Adaptive Behaviors in Adolescence

Roselló

Berenguer

Martı́nez-Raga

et al. 2021

JCM

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Within the autistic spectrum, there is remarkable variability in the etiology, presentation, and treatment response. This prospective study was designed to identify, through cluster analysis, subgroups of individuals with ASD without intellectual disability (ID) based on the severity of the core symptoms in childhood. The secondary aim was to explore whether these subgroups and a group with typical development (TD) differ in cognitive, adaptive, and social aspects measured in adolescence. The sample at baseline was comprised of 52 children with ASD without ID and 37 children with TD, aged 7–11. Among the ASD group, three clusters were identified. Cluster 1 (40%), ‘high severity’, presented high symptom severity on the DSM-5 criteria and the Social Communication Questionnaire. Cluster 2 (34%) showed ‘moderate severity’ on most of the scores. Cluster 3 (25%) corresponded to ‘low severity’, showing moderate social impairment and low restrictive, repetitive patterns of behavior, interests and activities. At 5-year follow-up, 45 adolescents with ASD without ID and 27 adolescents with TD were assessed. All clusters had significantly more difficulties in EF, ToM, socialization and adaptive behavior compared to TD. Social and adaptive trajectories between the ASD subgroups were relatively different; Cluster 3 showed poorer socialization and daily living skills than the other two subgroups. These findings highlight the importance of fully assessing social, cognitive, and adaptive profiles to develop care plans tailored to specific needs.

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Exploring Developmental and Behavioral Heterogeneity among Preschoolers with ASD: A Cluster Analysis on Principal Components

Cited by 37 publications

References 51 publications

Distinct patterns of cognitive outcome in young children with autism spectrum disorder receiving the Early Start Denver Model

Distinct patterns of cognitive outcome in young children with autism spectrum disorder receiving the Early Start Denver Model

Latent Structure of Combined Autistic and ADHD Symptoms in Clinical and General Population Samples: A Scoping Review

Subgroups of Children with Autism Spectrum Disorder without Intellectual Disability: A Longitudinal Examination of Executive and Socio-Adaptive Behaviors in Adolescence

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